Pain Doctor
by med-anomaly
Summary: House visits a pain specialist and gets a new pain management plan that throws Wilson for a loop. HW established relationship. Originally a follow up to Hugs Before Drugs, but can be read independently.


"Want a ride?" Wilson offers without expectation. House had his first appointment with his new pain management specialist today and Wilson wasn't sure if he should go along. He wanted to be a supportive partner, but knew that with House that meant respecting his choices.

"I don't think that's a good idea," House replies as he shrugs on his jacket. The whole point of all this was to separate Wilson from being his doctor. It would be too easy for him to fall back into that role if he came along. "I'll tell you about it later," House adds to assuage the rejection spilling across Wilson's face.

"Okay, but I'm holding you to that," Wilson says in farewell.

The caterpillar climb is nearly instantaneous. Wilson's eyebrows quickly meet his hairline in avid question the moment House returns.

"How'd it go?" he asks when House settles in next to him.

"Fine. What's for dinner?" House asks glancing toward the kitchen.

"It's later," Wilson says knowing he'll have to remind and push House to tell him what happened.

"What's for dinner, Wilson?" House asks in his 'don't poke the tiger' tone, warning Wilson to drop the issue.

"House," Wilson says emphatically, eyebrows climbing ever farther up his forehead.

"It sucked okay," House says in short reply, cursing the stupid eyebrows. He can never seem to refuse them or the eyes they shelter. "How about steak? We haven't had steak in a while."

"That's because red meat isn't very good for us. If you're not happy with this guy, we can find someone else," Wilson says sympathetically.

"He's fine," House says tersely. The anesthesiologist he'd chosen was good at what he did. "We could order in. I think we have a coupon for that Thai place on Main Street."

"Then what is so bad that you can't talk about it? What? Did he drop down your dose? Prescribe something you disagree with?" Wilson questions, growing frustrated.

"No," House replies quietly, frankly. "Seriously, you're not hungry? I'm starving."

"What happened House?" Wilson half shouts in exasperation.

"What do you think happened? He made me go through the pain scales and assessments and my history with the pain and pain management, looked at the images, did a physical, and then made with the meds," House says anger rising in him. He doesn't want to do this.

"What did he start you on?" Wilson asks curiously, knowing he'll get his answers soon. Anger meant House had realized he couldn't avoid sharing.

"I've spent all day talking about this shit, can we just drop it?" House attempts.

"Fine, just tell me what he prescribed and I'll leave it alone," Wilson persists. 

"No, you won't," House says, resigning himself to what comes next.

"All right, I won't, so you might as well tell me," Wilson urges.

"Here," House acquiesces, handing over several prescriptions.

"Kadian, Cymbalta, Baclofen, Zofran, Miralax and Dilaudid for breakthrough pain," Wilson reads to himself.

"Yeah," House says softly because it feels like Wilson asked a question. He stares intently at a book on the shelf, unable to face Wilson. House may pride himself on being an ass, but he has no desire to see Wilson looking like he just shot Bambi's mom.

Wilson is taken aback as he realizes the implication of this. He can't breath. He's sure his heart is trying to climb out through his throat blocking the flow of air. He feels the muscles in his face tighten as tension fills him. It takes him some time to digest all of this, to understand how profoundly he had failed House.

This new plan made a lot of sense. The time-release morphine in Kadian would offer sustained levels of opioid analgesia and the absence of the acetaminophen found in Vicodin would give House's liver a break. The extended release aspect of it would provide steadier pain relief. It even had less abuse potential than a drug like Vicodin. Cymbalta would work as an adjuvant for neuropathic pain and if it happened to also be an antidepressant, all the better. Baclofen was a solid muscle relaxant. He knew House suffered from neuropathy and spasm, but he had never managed to add anything to specifically address those types of pain to his regimen. He had never added a different medication for breakthrough pain either, but knew that it too made sense. The opioid analgesic equivalence scale placed Dilaudid at roughly seven times more potent than Morphine, and he hadn't offered House anything but an ever increasing dose of Vicodin for the bad days. The Zofran to control nausea was unexpected, the Miralax wasn't. He didn't realize that nausea had been an issue for House before. He knew that constipation was. Processing the clinical benefits of the management plan seemed to help because at last his lungs seemed to work again, and his organs returned to their rightful places.

"And you agree with his assessment?" Wilson asks quietly.

"Yeah," House says still refusing to look at Wilson.

"I…I'm so sorry," Wilson says, heartbroken.

"Don't be," House says sincerely, finally looking back at his partner.

"You never said anything," Wilson says defensively.

"What was I supposed to say? You were always hounding me to take less Vicodin as it was. How exactly do you think my asking for something stronger or additional drugs would have gone over?" House asks trying to keep accusation out of his tone.

"The lack of acetaminophen will be easier on your liver. Something that's extended release makes so much more sense - fewer peaks and troughs, less abuse potential. I recognize the importance of that for my patients all the time, and the adjuvants…I should have seen it," Wilson says speaking more to himself than to House.

"It's fine Wilson. I mean, wasn't that the whole point of all of this? For me to go to someone who sees me as only a patient," House says, wishing he was better at the whole comforting thing.

"Yeah, it was. I just, I didn't realize just how wrong I was for the job. I'm sorry," Wilson says feeling guilt and remorse from deep within.

"You already said that, and I already accepted. Look, I've had a shitty day. I've already fired Dr. Wilson. Please tell me you can drop this now so I don't have to fire Jimmy too? Little Jimmy would be so heart-broken," House says attempting a joke because it's the only way he can think of to make things better.

"Okay," Wilson says sadly.

"I can still feel you thinking about it," House says leaning his head on Wilson's shoulder.

"I let you go inappropriately and under-treated for so long. I can't just let that go," Wilson says honestly.

"I have," House insists trying to will the 'I ran over your puppy' tone out of Wilson's voice.

"I should have seen it."

"I didn't want you to," House admits.

"What?"

"I didn't want you to. It's easier to tell Lau," House says, figuring the truth is probably the quickest parachute back to their safe territory.

"If you can't be honest with me-" Wilson starts, concern for the life they're building burning brightly.

"Relax, about most things, I can. That chicken thing you cooked last night was disgusting. See? No problem. The pain stuff is different," House says in what he hopes is a reassuring tone.

"How?" Wilson asks realizing House is in a rare candid mood.

"It already hurts me enough for the both of us," House says quietly. "Now, seriously, what's for dinner?" he whines enthusiastically.

"Well, I was going to heat up some left-over chicken," Wilson teases understanding the significance of what House was sharing and his desire to put it away.

"We should get a dog," House declares as he cuddles closer.

"You hate dogs," Wilson says, breathing easy now. He puts an arm around House's shoulder. He still felt bad about under treating House's pain, and part of him probably always would, but they'd be okay.

"Yes, that's why we should get one. I can inflict your cooking on him," House says lightly.

"Fine, starve," Wilson smiles.


End file.
